1. Field of the Invention
The present invention relates to an apparatus and system for use in connection with intravenous fluid devices, and more particularly to a method, system and apparatus for increasing the accuracy of adding to or changing the intravenous fluid flow to a patient in hospitals, clinics, and other medical institutions.
2. Discussion of the Prior Art
The treatment of patient often requires the simultaneous administration of several intravenous solutions, and/or the use of intravenous catheters and monitoring devices for such measurements as central venous pressure, pulmonary artery and pulmonary wedge pressures. These solutions and catheters are routinely utilized following cardiac and pulmonary surgery or other major surgical procedures, in the treatment of shock or severe sepsis, and in the care of myocardial infarcts associated with major complications.
In order to administer these intravenous fluids and medicines, while at the same time monitoring various cardiopulmonary functions, multiple sites for introduction of the fluids are provided on the patient. For example, a subclavian vein catheter with multiple ports is commonly inserted above the clavicle and lateral to the neck into the subclavian vein, a single port catheter or needle is placed in a vein in the forearm, and often a third venous catheter or needle is used elsewhere on the forearm or hand. Four or more containers, more often plastic bags, containing intravenous fluids, often are suspended around the critically ill patient. Some of these are administered continuously, while others are used intermittently. The transport of the fluid from these containers to the patient is accomplished through the means of small gauge clear plastic tubes which are connected to a variety of needles and/or catheters inserted into the patient. The flow is either directly through these tubes or through intermediate mechanical pumps or measuring devices to more accurately adjust the flow rate of fluids.
However, the number of fluid containers usually exceeds the number of intravenous portals into the patient. A common way of overcoming the problem is to place a flow control means such as two and three way stopcocks interposed in the intravenous lines, with two or more bottle effluent lines flowing into the stopcocks and one line flowing out towards the patient, and/or with an intravenous line flowing into a rubber tipped side port from which one line flows out to the patient. This latter method is often referred to as a "piggyback" method. These side ports are found on most intravenous tubing for this purpose. Such "Y"s fulfill another very important purpose in emergency situations where it is necessary to administer medication to the patient immediately. When this occurs, a needled syringe is inserted into the stoppered appendage and medication is injected directly through the side port and through the output tubing into the vein of the patient. This method is routinely used in administering drugs, especially to the critically ill patient or to one who is unable to take oral medication.
Not only must the correct medication be introduced into the patient, but it is also extremely important that the medication be entered into the proper portion of the patient's body. For example, a patient might have intravenous input ports in the arms or hands, which input medication into the peripheral system, and other ports in the upper body which lead to the subclavian vein or past the heart into the pulmonary artery without passing through the peripheral system. The difference is important. Most direct intravenously administered drugs should be introduced into the peripheral circulation for a dilutional effect before entering the heart and lungs. Some drugs are potentially dangerous if injected directly in the heart chambers or the pulmonary artery. As a result, the nurse must be careful to select the proper port for the injection. In addition, if the medication from one container is to be combined in introduction with medication from another container it is important that the containers be properly selected so that a deleterious or dangerous combination does not occur.
But there exists the potential of making a mistake in selecting the tubing which leads to the proper port, as well as in selecting the tubing already carrying medication with which the new medication is to be combined. The patient is usually surrounded by a bewildering array of intravenous containers, mechanical pumps, and intravenous tubing, with the latter traversing the bed like spaghetti before finding its way either directly into the patient or through a needle into another line or perhaps through a stopcock into another tube and into the patient. The bottles are remote from the patient, the lines are tangled, and it is difficult to be certain that the newly administered, continued, or changed medication is going into the proper body port. When containers become empty, when intravenous tubing needs to be replaced, and especially when direct intravenous medication is required, the nurse must carefully search out the origin and insertion of a specific bottle or line, confirm that the line is operable, and be certain that the drug be administered into the proper intravenous portal. The procedure is time consuming and sometimes frustrating, and in an emergency situation, such as cardiac arrest, the delay can be deleterious to the patient. Moreover, if the wrong port is chosen, due to the confusion resulting from the tangling misalignment it can be extremely dangerous and sometimes even fatal. In addition to the ordinary tendency for confusion and error, the matter is exacerbated during the transportation of the patient to a stretcher or wheelchair, or in turning the patient or making up the bed when the complex of lines tend to become twisted or pulled. The problem is still further complicated by the fact that the new or additional medication is not inserted directly at the portal to the body, but rather at a more removed portion on the tubing length which leads from the portal where the "Y", or other connectors or valves are located. Because such connectors and valves are located remotely from the body portals and from the containers the confusion resulting from the maze of lines is increased, particularly where the personnel involved are fatigued or rushed. What is needed is a method of accurately determining, often under conditions of urgency and stress, and sometimes of fatigue, what fluid is flowing in a particular line, and what is the body port to which what medication is flowing, despite the entangling complexity of tubing, the shifting position of bottles relative to the patient, and the constant changing of the medicinal requirements, and without having to commit to memory something like a color code.
Therefore, an object of the present invention is to provide a system and apparatus for permitting rapid and accurate identification of the fluid flowing through IV tubing in the area of the Y-Connector , or other connector or valve where new fluid is to be inserted into the tubing.
Another object is to provide a system where cross checking to be sure the new or additional IV fluid is inserted in the correct tubing is prompted, encouraged and facilitated, yet where the total installation time is not adversely affected or wherein the installation is too complicated or made a chore which the nurse may want to avoid or circumvent.
An additional object is to provide a system which is easy to learn, and which employs habits already ingrained in the nursing profession so as to enhance its use.
Another object is to provide a device which can readily be integrated into an effective system, and yet which is inexpensive so that it can be readily replaced to maintain the cleanliness and enhance the sterility of the environment in which it is used.
An additional object is to provide a system which can accomodate the constantly changing circumstances and nature of administration of medication to a patient over the time period that the patient is in need of intravenous introduction of medication.
A still further object is to provide a system which not only provides for correct installation, but provides a temporary or permanent record of the fluid which was admininstered over a period of time.